双钢板结合MIPPO技术治疗胫骨近端复杂骨折

Double Plates with MIPPO Technique in Treatment of Complex Proximal Tibia Fractures

目的评估应用双钢板结合MIPPO技术治疗胫骨近端复杂骨折的临床效果。方法自2008年7月至2011年10月,收治胫骨近端复杂骨折19例。根据AO分型,41-C2型14例,41-A3型3例,41-C3型2例;开放性骨折7例,其中CustiloⅠ型5例、Ⅱ型2骨折。本组患者均予以双钢板手术治疗,术后评估骨折愈合情况,包括关节功能、步态、关节疼痛等。结果本组患者术后随访8～24个月,19例均骨折愈合,骨折愈合时间为3～5个月。术后评估结果:优12例,良5例,可1例,差1例。本组患者均未出现严重并发症。Merchant评估优良率达89.5%。结论双钢板结合MIPPO技术是治疗胫骨近端复杂骨折的良好方法。

Objective To summarize and evaluate the technique and clinical outcomes of double plates for treatment of complex proximal tlbial fractures. Methods From July 2008 to October 2011, 19 cases of complex proximal tibial fractures were enrolled in this study and were treated by double plates technique. According to AO classification, there were 14 cases in type 41-C2, 3 cases in type 41-A3,2 cases in type 41-C3. There were 7cases of open fractures and 5 cases in Custilo I , 2cases in Custilo Ⅱ . X-rays were taken in the regular follow-up. Bone healing time, knee function, joint pain and complications were observed and recorded. Results The follow-up time was 18.3 months （15 to 24 months）. All cases got bone healing with average 4.3 months. There were no complications of wound infection, skin and flap necrosis or implant failure. There was no post-traumatic arthritis occurred during the follow-up. The function was excellent in 12 cases, good in 5 cases, fair in 1 case and poor in 1 cases. Conclusion Double plates is proved to be a safe and reliable technique to treat complex proximal tibial fractures.